Doctors’ predictions of when terminally ill patients will die vary widely

Research has shown a wide variation in doctors’ ability to predict accurately how long terminally ill patients have to live.

Some clinicians underestimated a person’s death by 86 days, while others suggested patients had 93 days longer to live than they did.

The team at the Marie Curie Palliative Care Research Department at University College London (UCL) examined more than 4,600 medical notes where survival rates had been predicted.

They also found that more experienced or older doctors were no more accurate in predicting time of death than their younger, less experienced colleagues.

Exact science

Responding to the findings, the RCN said predicting the timing of a person’s death was not an ‘exact science’ and nurses are as open as possible about the situation.

RCN deputy director Stephanie Allen said: ‘For a dying person and their loved ones, uncertainty can make a distressing time much harder to deal with.

‘Just as when we are born, the precise timing of death can be an inexact science. But nurses looking after people at the end of their lives recognise the positive impact of being as open as possible about what is observed, even if definitive answers cannot be given.’

Supporting families

She added that there is more to do to improve recognition of the signs that someone is dying and to support families with information.

Further work is being undertaken to see if it is possible to train doctors to better predict survival rates in terminally ill patients.

Paddy Stone, professor of palliative and end of life care at the UCL research department, said: ‘Being more senior or more experienced does not necessarily make one a better prognosticator, but we now want to see if we can identify how and why some doctors are better at predicting survival than others, and to determine if this is a skill that can be taught.’

Further information

A Systematic Review of Predictions of Survival in Palliative Care: How Accurate Are Clinicians and Who Are the Experts?